It says the issue is very tough politically. It says Washington is unresponsive to the interests of the American people, who overwhelmingly want healthcare reform. It says insurance companies, pharmaceutical companies and other health industry special interests (including the AMA until just last year) are exceptionally powerful with "the American polity" and like the status quo.

Also, to suggest this package is a "wholesale government takeover" is intellectually dishonest. The bill doesn't expand government-run insurance by a whit. It simply builds upon existing regulations and subsidies while relying purely on private insurers to expand coverage.

It says the Democrats' communications strategy has been weak. It says they upset their base by ignoring universal healthcare and not fighting for the public option. It says they upset independents by not sticking by a clear set of convictions. It says they wasted far too long trying to fruitlessly court Republican votes.

Conversely, what does it say that a tremendous majority of the American public has for many years favoured a sweeping healthcare overhaul? What does it say that a measly 4% of Americans, according to a new Associated Press poll, are satisfied with the current system?

3. What does it say that Democrats are having this much difficulty enacting their healthcare legislation despite unified Democratic rule? Despite large supermajorities in both chambers of Congress, including a once-filibuster-proof Senate majority (see more below)? Despite an opportunistic change in Massachusetts law that provided that crucial 60th vote at a crucial moment? Despite a popular and charismatic president?

It says Democrats are not very effective at fighting for progressive change. It says some party members are too subservient to special interests. It says they made a series of strategic blunders (like the Pharma backroom deal) that damaged their credibility. It says Republicans are very good at obstruction, however discredited or small in numbers they are.

4. What does it say that 38 House Democrats voted against the president's health plan?

In addition to the above, it says the Democratic party is ideologically diverse and that some of its lawmakers represent Republican-leaning districts.

5. What does it say that Massachusetts voters elected, to fill the term of Ted Kennedy, a Republican who ran against the healthcare legislation that Kennedy helped to shape?

It says Martha Coakley ran a lousy campaign and probably should have known who Curt Schilling is. It says the Democratic party has underperformed and is losing steam. It says the progressive base is disheartened while teabaggers and Republicans are energised. It says nothing about healthcare reform. Massachusetts has universal healthcare (which Scott Brown voted for) and is very happy with it.

6. What does it say that the only thing bipartisan about that legislation is the opposition to it?

It says the Republican party has shrivelled to a small group of hard-right ideologues. It says the GOP feels exceptionally threatened that Democrats may achieve a historic victory that improves – if not saves – the lives of millions. It says the GOP is cracking the whip of party discipline harder than ever, which Democrats don't do quite as well.

It says they really want to get rid of the bill's dodgy giveaways, like the Nelson deal, before it becomes law. Both chambers have already passed healthcare reform with a majority or a supermajority. This strategy (which may not even be used) is simply a motion wherein the House stamps its approval on the Senate bill under the condition that the special deals are eliminated.

11. Given that ours is a system of government where ambition is made to counteract ambition, what does it mean that the only way to pass this legislation is for the House to trust that the Senate will keep the House's interests at heart?

It says the legislative process is complex, especially when it comes to passing comprehensive reforms. It says the Democratic leadership still has some battles to fight before declaring "mission accomplished".

And while we're asking questions, I have one of my own, for thoughtful opponents of ObamaCare: what does it say that the most fervent self-proclaimed fiscal conservatives are among the biggest opponents of a bill that will cut – that's right, cut – the deficit by $118bn dollars over a decade, according to yet another CBO analysis?